Schmid Katharina E, Boszczyk Bronek M, Bierschneider Michael, Zarfl Andreas, Robert Björn, Jaksche Hans
Department of Neurosurgery, Berufsgenossenschaftliche Unfallklinik Murnau, Germany.
Eur Spine J. 2005 Nov;14(9):895-9. doi: 10.1007/s00586-005-0905-7. Epub 2005 May 24.
Spondylitis is a rare complication of vertebroplasty with only one case report having been published to date. We report a further case of spondylitis after vertebroplasty that was managed successfully with conservative therapy.
The clinical course of a 55-year-old patient with secondary osteoporosis due to liver cirrhosis from alcohol abuse is reported, in whom percutaneous vertebroplasty of three fractured vertebral bodies (L3-L5) was complicated by spondylitis at these levels.
Spondylitis of L3-L5 with paravertebral abscess formation and progressive collapse of L5 was detected by magnetic resonance imaging (MRI). Treatment consisted of percutaneous aspiration of the paravertebral abscess and antibiotic therapy. No bacteria was identified despite cultures have been taken before antibiotic treatment. The patient was treated with intravenous ciprofloxacin and consecutive clindamycin for a total of 3 months. One year after the infection the MRI signs of spondylitis have resolved without further collapse of L5. Painlevels have improved significantly, allowing the patient to return to work, but are still higher than immediately after vertebroplasty.
Spondylitis is a rare complication of vertebroplasty. In the presented case a satisfactory result could be achieved through conservative antibiotic therapy and restriction of movement.
脊柱炎是椎体成形术的一种罕见并发症，迄今为止仅发表过一例病例报告。我们报告了一例椎体成形术后发生脊柱炎的病例，该病例通过保守治疗成功治愈。
报告了一名55岁因酒精性肝硬化导致继发性骨质疏松患者的临床病程，该患者对三个骨折椎体（L3-L5）进行经皮椎体成形术后，这些节段并发了脊柱炎。
磁共振成像（MRI）检测到L3-L5节段脊柱炎伴椎旁脓肿形成及L5椎体渐进性塌陷。治疗包括经皮穿刺抽吸椎旁脓肿及抗生素治疗。尽管在抗生素治疗前已进行培养，但未鉴定出细菌。患者接受了静脉注射环丙沙星及随后的克林霉素治疗，共3个月。感染发生一年后，脊柱炎的MRI征象消失，L5椎体未进一步塌陷。疼痛程度显著改善，患者能够重返工作岗位，但仍高于椎体成形术后即刻的疼痛程度。
脊柱炎是椎体成形术的罕见并发症。在本病例中，通过保守的抗生素治疗及限制活动可取得满意结果。
